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I started a job a month ago with a state mental hospital. I was happy to get a job as a new grad, and they said they would give me 6 weeks of training. However, being in the unit, I've been feeling extremely overwhelmed. Many nurses and psych techs have been attacked by patients from broken ribs to punctured lungs and concussions, stabbing with pens...scary stuff! I was training in the Patient Observation Unit (the Psych hospital ER) and that was not as scary (the patients are only there for a minimum of 3 days and they're more being observed). Recently, I started training on the inpatient unit. I'm very concerned here because due to budget cuts, they have cut back a lot on staffing (there are 18 patients to 1 RN and 2 psych techs. A lot of these patients have a history of violence, many coming from the prison system, angry to be there, and unpredictable.
I am concerned doing med pass on this many patient as a new grad and making med errors. I'm concerned with my safety (the patients have free reign on the unit and are wandering around, constantly at the nurses station making threats and yelling). They say don't turn your back on the patients, but I don't see it possible to do this because they are all around me! I'm really not sure this is the right position for me or if it's worth risking my safety. As a new grad, I know there are not many options right now and it would be good to get experience. But I'm just feeling very scared and uncomfortable there. Any recommendations?
I was actually very interested to work in a prison! In California, they pay very well and I've heard lots of good things from some of my nursing classmates who got jobs in the prisons. I had a couple of interviews, but it is competitive and also takes awhile with the state. But I heard security is much better in the prison. Do you also get harassed there by inmates or threatened, or do the correctional officers keep them in line?
Security is much better in the prison environment. This is why state psychiatric hospitals are so dangerous - many patients are there, court-ordered due to danger to others - but where is the security?
It is rare for me to get harassed or threatened by an inmate. I wouldn't say the correctional officers keep them in line verbally. Physical safety, yes. Verbally, it depends on the officer, but usually it's up to me to decided when a bad verbal exchange is done. I can tell you this - I do not permit an inmate to use vulgar language when talking with me unless they are suicidal, seriously depressed, or in critical condition. I say, "Please, no vulgar language around the nurse." And most of the time they look puzzled, then they 'get it' and that stops it.
I really don't deal with much abuse. I think the average ER nurse experiences worse.
I love working in psych, so I'll take the state psych job while Multicollinearity takes the job at Denny's for me :)
That being said...OP: get yourself out of there, or get yourself transferred to a less acute unit. State psych hospitals are not the place for a new grad, especially as the only nurse on a poorly staffed high acuity unit.
And if you are not feeling safe, trust your gut. Even I wouldn't stay at any psych job that I didn't feel safe at. There's always going to be some risk--it is psych, after all--but it should not be an overwhelming risk.
I love working in psych so I'll take the psych job while Multicollinearity takes the job at Denny's for me :)That being said...OP: get yourself out of there, or get yourself transferred to a less acute unit. State psych hospitals are not the place for a new grad, especially as the only nurse on a poorly staffed high acuity unit.
Meriwhen,
I just want to be clear - I was picking Denny's over a state psych hospital due to the physical risk involved and intensity of disorders in a government psych hospital. Not referring to all of psych this way. I think it's a terrible, horrible place for a new grad. That kind of job calls for a seasoned psych nurse (and proper security from the employer!).
Meriwhen,I just want to be clear - I was picking Denny's over a state psych hospital due to the physical risk involved and intensity of disorders in a government psych hospital. Not referring to all of psych this way. I think a state hospital is a horrible place for a new grad. That kind of job calls for a seasoned psych nurse (and proper security from the employer!).
I know--I hit Post before I was done, and was editing my post to include the state part at the same time you posted this :) And I definitely agree that state facilities are not for the new grad.
I liked my psych rotation in nursing school. I was at the VA and many of the patients had PTSD. I know safety was an issue there, but I felt challenged and not overwhelmed. The facility I'm at now is a lot more intense and a lot less staff. The whole Denny's thing I think is a joke too. I really hope to actually find a nursing job after going to school so long- it's just hard because there's not a lot out there. That's why I took this job with the state. They are giving me 6 weeks of training (3 on the actual unit). I have 2 weeks left of training, but still feel really overwhelmed and like they think I'm dumb because I don't know a lot of what they do. There is a lot of paperwork and the med pass is also overwhelming- in nursing school, we'd pass meds on 2 or 3 patients and do all of their care. Meds on 18-20 patients, plus all the paperwork and admissions and discharges, and dealing with the yelling and screaming and fighting has me a bit thrown. I am scared that in 2 weeks, I won't be ready to be on my own
I liked my psych rotation in nursing school. I was at the VA and many of the patients had PTSD. I know safety was an issue there, but I felt challenged and not overwhelmed. The facility I'm at now is a lot more intense and a lot less staff. The whole Denny's thing I think is a joke too. I really hope to actually find a nursing job after going to school so long- it's just hard because there's not a lot out there. That's why I took this job with the state. They are giving me 6 weeks of training (3 on the actual unit). I have 2 weeks left of training, but still feel really overwhelmed and like they think I'm dumb because I don't know a lot of what they do. There is a lot of paperwork and the med pass is also overwhelming- in nursing school, we'd pass meds on 2 or 3 patients and do all of their care. Meds on 18-20 patients, plus all the paperwork and admissions and discharges, and dealing with the yelling and screaming and fighting has me a bit thrown. I am scared that in 2 weeks, I won't be ready to be on my own
If you are seriously concerned for your safety, I would leave. If you are feeling overwhelmed about the nursing aspects, I would reconsider and explore it more.
Hi there,
I have an interview lined up next week for a state psych hospital and I can relate to everything you are saying. I am also a new grad and the fact that I have not had any luck finding work that is a good fit and graduated in 2010 made me consider this psych position. In the back of my mind I am thinking okay this is probably not the best area for a new grad and I am not exactly someone who can safely defend myself from someone who is outraged. I can relate because I too just want to get experience and find something that makes me feel good. My advice to you is if your gut feeling is questioning your safety and you are not sure that this is the right fit, it is probably not the right fit. It is just not worth your safety. I have known people who worked in that setting, were injured, and would give anything to take it back.
Thanks for everyone who posted it helped me make up my mind on this position and am going to keep looking for other opportunities.
Woodflower, maybe your experience will be better. I have not personally been attacked, but I've been on the unit for only 2 weeks. I've seen a few take downs and they also do B52 injections in the buttocks when the patients get agitated and out of hand. You will feel like you always have to watch your back- even when you leave the hospital. Maybe it will help with becoming more "tough"- they told me I can't be nice in this setting. But I went into nursing to be able to help people. Woodflower, I'd find out about the nurse-patient ratios at your hospital and also make sure they have a good new grad program because it's important to learn the right way. Unfortunately, we don't have a lot of options as new grads so we sort of feel like we have to take whatever we can get. I'm looking into home health and hospice. Hoping to at least have something else lined up before I leave this job, but if I really feel in danger, I might just quit. Hopefully my family will understand.
GypseyGirl
39 Posts
I was actually very interested to work in a prison! In California, they pay very well and I've heard lots of good things from some of my nursing classmates who got jobs in the prisons. I had a couple of interviews, but it is competitive and also takes awhile with the state. But I heard security is much better in the prison. Do you also get harassed there by inmates or threatened, or do the correctional officers keep them in line?